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The Developmment and Critique of the Social Model of Disability
 

The Developmment and Critique of the Social Model of Disability

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The Developmment and Critique of the Social Model of Disability
The objective of this paper is to provide a description and analysis of the social model of
disability, and how it has developed during the past 30 years. Both academics working
in the field of disability studies, as well as practitioners providing disability services
have been increasingly influenced by its underpinning philosophy. Furthermore, the
“disability movement” utilises the social model as a political platform and tool to secure
the “rights” of disabled people, with the objective of ensuring that they enjoy the status
of full citizenship within contemporary society.
The social model of disability should not be considered as a monolithic entity, butrather
as a cluster of approaches to the understanding of the notion of disablement.

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    The Developmment and Critique of the Social Model of Disability The Developmment and Critique of the Social Model of Disability Document Transcript

    • THE DEVELOPMENT AND CRITIQUE OF THE SOCIAL MODEL OF DISABILITY Dr. Raymond Lang Senior Research Associate Overseas Development Group University of East Anglia January, 2001
    • 1. IntroductionThe objective of this paper is to provide a description and analysis of the social model ofdisability, and how it has developed during the past 30 years. Both academics workingin the field of disability studies, as well as practitioners providing disability serviceshave been increasingly influenced by its underpinning philosophy. Furthermore, the“disability movement” utilises the social model as a political platform and tool to securethe “rights” of disabled people, with the objective of ensuring that they enjoy the statusof full citizenship within contemporary society.The social model of disability should not be considered as a monolithic entity, but ratheras a cluster of approaches to the understanding of the notion of disablement. As will bedemonstrated below, different variants of the model ascribe differing and relativeimportance to a multiplicity of factors that result in the oppression and discriminationthat disabled people experience. However, common to all variants of the social model isthe belief that, at root, “disability” and “disablement” are socio-political constructions. Itis therefore the inhospitable physical environment, in concert with the negative socialattitudes that disabled people encounter which result in the systematic oppression,exclusion and discrimination of disabled people.It can therefore be appreciated that the consideration of the theoretical understandings 2
    • of disability are not solely of semantic, academic interest. The manner in whichdisability is popularly perceived has a profound impact upon the way in which“stakeholders” are considered (by disabled person’s organisations, policy makers andNGOs alike) to have a legitimate role in deciding how resources are distributed. Themanner in which disability has been variously conceptualised, with the resultantramifications for the provision of disability services, has become a highly emotive andpolitically charged issue.2. The Origin and Basic Tenets of the Social Model of DisabilityThe social model arose in response to the critique of the medical model of disability. Ithas generated a caucus of academic writing, predominantly written by academics andactivists who themselves have disabilities and is the total antithesis to the medicalmodel. It is not intended to provide a comprehensive review of the medical modelwithin this paper, but to refer to it in relates to the social model. The primary focus ofanalysis is the manner in which the social model shifts away from consideration of thedeficits of the functional, physiological and cognitive abilities of the impairedindividual, to the ability of society to systematically oppress and discriminate againstdisabled people, and the negative social attitudes encountered by disabled peoplethroughout their everyday lives. Disability is therefore situated in the wider, externalenvironment, and is not explicable as a consequence of an individual’s physical and/orcognitive deficiencies. Thus, in focusing upon the manner in which disability is socially 3
    • produced, the social model gives precedence to the importance to politics,empowerment, citizenship and choice. Furthermore, disability is the result of society’sfailure to provide adequate and appropriate services. Consequently, the needs ofdisabled people are not adequately accounted for within the contemporary socialorganization of society. It is perceived in attitudinal terms - as a socio-cultural ratherthan a biological construct. Harlan Hahn, writing within the North American context,stated that disability stems from:- “the failure of a structured social environment to adjust to the needs and aspirations of citizens with disabilities rather than from the inability of the disabled individual to adapt to the demands of society.” (Hahn, H. 1986:128)A further central tenet of the social model is that, irrespective of the political, economicand religious character of the society in which they live, disabled people are subject tooppression and negative social attitudes, that inevitably undermine their personhoodand their status as full citizens. Underlying the notion that disabled people areoppressed is the assumption that all societies are characterized by conflict between twocompeting groups; the dominant and the subordinate. Writing within the context of thepolitics of disability, James I. Charlton defined oppression as follows:- “Oppression is a phenomenon of power in which relations between people and between groups are experienced in terms of domination and subordination, superiority and control. Those with power control; those without power lack control. Power presupposes political, economic and social hierarchies, structured relations of groups of people, and a system or regime of power. This system, the existing power structure, encompasses the thousand of ways some groups and individuals impose control over others.” (Charlton, J. 1998:30) 4
    • Charlton also maintains that the majority of disabled people have been sopsychologically oppressed by society that their oppression has become internalised. Asa result, they have developed a Marxian notion of “false consciousness”, whereby theycome to believe that they are less capable than others. Consciousness can be defined asan awareness of oneself in the world. It is a process of awareness that is influenced bysocial conditions, chance and innate cognition. With regard to “false consciousness”, asa lethal mixture of self pity, self-hate and shame, this state of awareness can:- “… prevent people with disabilities from knowing their real selves, their real needs, and their real capabilities and from recognising the options they in fact have. False consciousness and alienation also obscure the real source of oppression. They cannot recognise their self-perceived pitiful lives are simply a mirroring of a pitiful world order. In this regard people with disabilities have much in common with others who have internalised their own oppression”. (Charlton, J. 1998:27)Paul Abberley (1987) has also analysed the concept of social oppression as it applies todisabled people. He argued that other groups within society, such as women and ethnicminorities, encounter oppression, but that is not possible to construct a monolithictheory that provides an adequate explanatory framework to comprehensively analysethe phenomenon for all marginalised groups. Social oppression is specific in themanner in which it operates in relation to form, content and location, “so to analyse theoppression of disabled people in part involves pointing to the essential differencebetween their lives and other sections of society, including those who are, in other ways,oppressed”. (Abberley, P. 1977:163). Abberley delineates four supplementary definingcharacteristics of social oppression as it relates to disabled people. He stated:- “To claim that disabled people are oppressed involves, however, arguing a number of other points. At an empirical level, it is to argue that on significant 5
    • dimensions disabled people can be regarded as a group whose members are in an inferior position to other members of society because they are disabled people. It is also to argue that these disadvantages are dialectically related to an ideology or group of ideologies which justify and perpetuate the situation. Beyond this it is to make the claim that such disadvantages and their supporting ideologies are neither natural nor inevitable. Finally, it involves the identification of some beneficiary for this state of affairs”. (Abberley, P. 1987:163)Social oppression in turn gives rise to institutional discrimination, analogous to thatexperienced with sexual and racial discrimination. Barton (1993) on commenting uponthe meaning of institutionalised discrimination within the British context stated:- “An extensive range of research findings has demonstrated the extent of the institutional discrimination which disabled people experience in our society. This involves access and opportunities in relation to work, housing, education, transport, leisure and support services. Thus, the issues go far beyond the notion that the problem is one of individual disabilist attitudes. These are not free floating but are both set within and structured by specific, historical, material conditions and social relations. Goodwill, charity and social services are insufficient to address the profundity and stubbornness of the factors involved”. (Barton, L. 1993:242).Disabled people have been subjected to a multiplicity of oppressive social attitudesthroughout history, which have included “horror, fear, anxiety, hostility, distrust, pity,over-protection and patronizing behavior” (Barton, L. 1996:8). Such pejorativeattitudes, coupled with an inhospitable physical environment such, as inaccessiblebuildings and unusable transport systems, are considered to be the real concerns ofdisability. (Barnes, C. 1991). It is therefore maintained that “disabled people live withina disabling world”. 6
    • 2. The Historical Materialist Variant of the Social ModelSince the 1960s, some disabled people, particularly those aligned with the “radicaldisability movement” in the UK and the United States, have attempted to develop atheoretical understanding of the concept of disablement, from a socio-politicalperspective. The early writers in this field were strongly influenced, as will bedemonstrated below, by structuralist and Marxist sociology. The theoreticalfoundations of the social model have developed during the ensuing period, embracingother schools of sociological thought. However, it is important to review these earlywritings in some detail, for they provide a basis for understanding how the model hassubsequently developed.Foundational to the materialist understanding of disability is the important conceptualdistinction drawn between impairment and disability, the formal definitions providedby the Union of the Physically Impaired Against Segregation cited in Box 1 below.Box 1 Definition of Impairment and Disability (The Union of the Physically Impaired Against Segregation, 1976)  “Impairment (is) lacking part of or all of a limb, or having a defective limb, organism or mechanism of the body;  Disability (is) the disadvantage or restriction of activity caused by contemporary organisation which takes no or little account of people who have physical impairments and thus excludes them from the mainstream of social activities.”According to the definition cited above, the social construction of physically impaired 7
    • people as “disabled” arises, in the first instance, from the specific ways in which societyorganises its basic material activities (work, transport, leisure, domestic activities and soforth). Impairment is simply a bodily state characterised by malfunction of the physicaland/or cognitive abilities of the individual, as the result of altered physiology orpsychology, which defines the physicality of certain people.In a very embryonic account of the materialist explanation of disability, commentingupon the crucial distinction between disability and impairment, Paul Hunt, on behalf ofUPIAS, wrote:- “In our view, it is society which disabled physically impaired people. Disability is something imposed on top of our impairments by the way we are unnecessarily isolated and excluded from full participation in society. Disabled people are therefore an oppressed group in society. To understand this, it is necessary to grasp the distinction between the physical impairment and the social situation, called ‘disability’, of people with such impairment. Thus we define impairment as lacking part of or all of a limb, or having a defective limb, organ or mechanism of the body; and disability as the disadvantage or restriction of activity caused by a contemporary social organisation which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities. Physical disability is therefore a particular form of social oppression.” (UPIAS, 1976:3-4).A further tenet of the “materialist” thesis is that disability is not a fixed, absolutecategory, but has been defined differently throughout history, and order to understandthe contemporary position in which disabled people are situated, it is imperative toanalyse disability from an historical perspective. Furthermore, given the two premisesthat disability is a socio-political construction, and to a large extent is culturally 8
    • produced, disability theorists such as Oliver and Finklestein maintain that thephenomenon of disability can be adequately explained with reference to the “mode ofproduction” and the dominant ideological hegemony.Vic Finklestein (1980) was one of the pioneers in developing a materialist explanation.He postulated that history can be divided into three “distinct and sequential phases”,and that within each phase, the manner in which disabled people are socially includedor excluded within contemporary society will differ. Firstly, the period before theEuropean industrial revolution was characterised by agrarian feudalism and somecottage industries. During this period, there was scant social mobility, and this mode ofproduction did not preclude disabled people from active participation in their localcommunities. During the second phase, spanning the industrial revolution and itsimmediate aftermath, disabled people were effectively excluded from being in paidemployment, due to the fact that they were not able to maintain the pace set by thefactory system. As a consequence, disabled people were separated and thereby sociallyexcluded from mainstream social and economic activity. Finkelstein maintained thatduring the third phase, which was just commencing, disabled people will witness andexperience their liberation from social oppression. This will be achieved throughdisabled people and their allies working collaboratively to achieve commonly agreedgoals, through the aegis of the disability movement. 9
    • 2.1 Oliver’s Analysis of DisablementMike Oliver, in his seminal work, The Politics of Disablement (Oliver, M. 1990) hasproduced a variant of the social model of disability. This construction is considered atsome length, for it constitutes the foundation for the subsequent development andmaturation of disability studies, particularly in the UK and the United States. Themodel is constructed and expressed in Marxist terms, and assumes that human nature,and the resultant choices that individuals can make for themselves, are determined bythe structure and ideology of society. It is therefore argued that the kind of society inwhich a disabled person lives has a profound effect upon how their disability isexperienced and structured. Furthermore, an individual’s personal experience ofdisability within capitalism is itself defined, to some extent, by the structural features ofcapitalism including ideology, culture and the influence of race and gender as well asthe activities of key groups and institutions (professionals and professionals). Theoverall purpose of Oliver’s analysis is to provide conclusive evidence that disability “as a category can only be understood within framework which suggests that it is culturally produced and socially structured.” (Oliver, M. 1990:22).Oliver began his analysis by questioning whether the medicalised, and tragic conceptionof disability, which he observed to be prevalent within Britain in the late 1980s, hadbeen replicated across other cultures and societies, and also between historical periods.He concluded that the individualist, medicalised and tragic conception of disability wasindeed unique to capitalist societies. Oliver referred to and quoted the work of two 10
    • social anthropologists, Hanks and Hanks, who showed that within pre-capitalistsocieties, the spectrum of attitudes encountered by disabled people have varied from“ruler to outcast, from warrior to priest, from infant to aged” (Hanks, J. and Hanks, L.1980:12).Oliver’s analysis of the social structuring of disability is founded upon two concepts; the“mode of production” and the central core values, or ideology that are present withinany given society. Both interact and determine how disabled people are perceivedwithin their local contemporary societies. The former is understood to refer to the typeof economy and its constituent productive units, as well as the manner in whichproduction is organised - for example, through the network of family units, or throughthe factory system utilising wage labour. The latter concept refers to the basic valuesupon which a society is premised, which could be based upon religion, science andmedicine.Different ideological premises have profound implications for the explanation ofdisability. Oliver argued that in some societies, the presence of an impairment may notbe perceived by society in pejorative terms, as it has been seen as a sign of being chosen.Hence, Safilios-Rothschild has stated:- “Throughout history, discriminatory practices against the sick and disabled have varied greatly from country to country and from century to century; they have ranged from complete rejection and ostracism to semideification and the 11
    • according of special privileges and humours.” (Safilios-Rothschild, C. 1970:4)Oliver maintained that the economic structure and ideological hegemony of modernwestern society have had a major detrimental impact upon the lives of disabled people,and also other marginalised groups such as those with differing ethnic affiliations, orthose with homosexual orientations. The rise of the factory system and the introductionof individual wage labour transformed the “means of production”, resulting in theseparation of the home from the workplace, and in the marginalisation of disabledpeople, because they were unable to meet the demands of capitalist society. Disabledpeople have become further isolated from their family communities through theestablishment of closed and segregated institutions, (which first came into existence inthe late 19th century), whose function was to act as a mechanism for social control. Inthe latter half of the 20th century, closed and socially isolating institutions still existwhich “warehouse” disabled people - for example, within many so called “specialschools” and sheltered training workshops. However, during the past 20 years,throughout western-democratic societies, there has been a shift in government policytowards ensuring that disabled people live in community settings, where the package of“care” is bespoked to the individual needs. Within the UK context, this is referred to asthe “care in the community programme”, (Priestley, 1999).Oliver further argued that in the wake of capitalism, dominant ideologicalpresuppositions and modes of thought became commonly accepted, which again had 12
    • detrimental consequences for the lives of disabled people. Analogous to Gramsci’sdistinction between “organic” and “arbitrary” ideologies, He distinguished between“core” and “peripheral” ideologies, the latter being derived from the former. In relationto ideology, it was argued that the rise of capitalism necessitated the separation of workfrom home (as stated above), which in turn gave rise to the ideological construction ofindividualism, which became the “core” ideology vis-a-vis disability. Consequently, therise of capitalism gave rise to the premise that disability is in essence an individualpathology, since a distinction needed to be drawn between those considered “able-bodied”, (and by implication able to work), and those who were considered disabled.Hence, within the modern capitalist era, “disabled people could not meet the demandsof individual wage labour and so became controlled through exclusion”.This process of individualism gave rise to the peripheral ideologies of categorizationand medicalisation of disability. In order to make a valid distinction between thedeserving and undeserving poor, the agencies of the state assigned the medicalprofession the role of deciding who was disabled and who was not. This process,initiated during the 19th century, continues to have important ramifications forcontemporary service provision, where it is commonly assumed that the greatestproblems encountered by disabled people are directly related to their medicalconditions. The medical profession still has a great deal of influence in the manner inwhich disabled people live, invariably being seconded by agencies of the state to make 13
    • assessment of their needs and abilities, often in areas which have little to do with theapplication of medical science. Examples falling into this category would include theentitlement for financial grants, wheelchairs and other appliances, assessing the abilityof a person to drive, and selecting appropriate educational provision. A possibleexplanation of the continued, and some would argue expanding, influence of themedical profession in the lives of disabled people is that the profession has widened itsremit within the field of medical science to incorporate rehabilitation. Oliver, in supportof this thesis, quoted Albrecht and Levy:- “As demand for rehabilitation services increased and insurance benefits expanded, there was an incentive for physicians to enter the rehabilitation field. Under the aegis of designing comprehensive medical rehabilitation programs, hospitals, and physicians began to incorporate rehabilitation services into the medical model. Definitions of disabling conditions and appropriate treatment were expanded to include medical interventions and physical control”. (Albrecht, G. and Levy J. 1981:22).Oliver continued his analysis by arguing that the economic and social structures ofsociety, in combination with the dominant ideological hegemony, have resulted indisabled people being perceived as “dependent”. Consequently a great deal of thesocial welfare legislation enacted during the post-war period has compounded thisnotion. The term “dependency” is used in a two-fold manner. Firstly, welfare stateshave categorised entire groups of people, of which disabled people are but one, whohave become dependent upon the state for the provision of education, health care, aswell as financial support. Secondly, in specific relation to disability, attention has 14
    • focussed upon the functional limitations of disabled people who are perceived to beunable to care for themselves.There is also a professional basis for the creation of dependency. Many of the servicesprovided for disabled people, often within institutionalised settings, engender such astate. Traditionally, these services have been established and subsequently managedwith little or no regard of the needs and aspirations of disabled people. Furthermore,the profession-client relationship is itself dependency-creating, as undue power andinfluence is vested with the professional. The structure of the economy withinindustrial society has invested professionals with the function of acting as gatekeepersof scarce resources, (in terms of financial benefits, medical and rehabilitation services)and this inevitably affects disabled people’s lives.Despite cosmetic changes that have been made with regard to the professional-clientrelationship, Oliver remained pessimistic about changing this aspect of dependency. Hetherefore stated:- “Economic structures determine the roles of professionals as gatekeepers of scarce resources, legal structures determine their controlling functions as administrators of services, career structures determine their decisions about whose side they are actually and cognitive structures determine their practice with individual people who need help - otherwise, why would they be employed to help them? This is not just another attack on overburdened professionals, for they are as much trapped in dependency creating relationships as are their clients”. (Oliver, M. 1990:91). 15
    • The task of transforming modern industrial society, so that disabled people do in factlive as full and free citizens, devoid of social oppression and negative social attitudes, isprofoundly revolutionary. Merely by tinkering with and modifying the institutions ofthe welfare state, irrespective of whether it adheres to the ideological presuppositions ofcapitalism or socialism, will ultimately prove to be inadequate. The dominanthegemony of individualism, the medicalisation and categorisation of disability, and theresultant dependency of disabled people will remain unaltered. Furthermore, theraison d’etre of service provision needs to change from one that is based upon definingneeds (principally by able-bodied professionals), to one based upon social rights. Such amove would run counter to the dominant ideology of individualism that has hithertopervaded services provision, as well as beginning to break the cultural linkage betweenpolitical and professional dependency.In order for this to become a reality, thereby creating a “non-disablist” society, Oliverproposed a three-fold strategy. Firstly, states should enact anti-discriminationlegislation, thereby making it an offence to discriminate against disabled people in thefields of education, employment, housing and so forth. Secondly, within westernsocieties, more emphasis should be given to securing freedom of information, so thatdisabled people can have access to information that has previously remainedconfidential. 16
    • Thirdly, an infrastructure should be established in which the needs and aspirations ofdisabled people can be met, with the appropriate range of services being provided. Thiscan only happen with adequate state funding, to assist organisations of disabled peopleto secure their rights. Hence, it is ultimately disabled people themselves who aredefining how they wish to live their lives. In the last 20 years, organisations of disabledpeople have been established in the majority of countries throughout the world. Thevast majority adhere to the principles of “empowerment, and human rights,independence and integration, and self-help and self-determination” (Charlton, J.1998:130). In commenting upon the consequences of adopting a human rightsapproach to disablement, Dimitris Michailakis stated:- “A human rights approach implies legal reasoning. ... The human rights approach implies, thus, among other things, the creation of a legislation which shall give persons with disabilities and their organisations the lever to ensure that there is effective advocacy for their rights. ... Implicit in any application of the human rights’ strategy is structural transformation, involving redistribution of economic and political power. As in the struggle against racism, advocates and policy-makers chose to combat discrimination against persons with disabilities by reference to human rights.” (Michailakis, D. 1997: 19-20)This human rights approach to disability has been adopted, within the last decade, bythe United Nations, who in 1993 at its 85th Plenary Meeting of the General Assembly,passed the resolution “Standard Rules for the Equalisation on Opportunities for Persons withDisabilities” (United Nations, 1993). Although this internationally agreed documentdoes not have the status of a legally binding document upon any sovereign state, it hasnevertheless been very influential in the development of disability policy throughout 17
    • the developed and developing world. In explaining the rationale that underpins theStandard Rules, the Resolution stated:- "The term ‘equalisation of opportunities’ means the process through which the various systems of society and the environment, such as services, activities, information and documentation, are made available to all, particularly to persons with disabilities. The principle of equal rights implies that the needs of each and every individual are of equal importance, that those needs must be made the basis for the planning of societies and that all resources must be employed in such a way as to ensure that every individual has equal opportunity for participation. Persons with disabilities are members of society and have the right to remain within their local communities. They should receive the support they need within the ordinary structures of education, health, employment and social services.” (United Nations, 1993, Introduction, Paragraph 25)3. The Development of the Social Model of Disability3.1 Experience, Embodiment and the Social ModelIt is beyond doubt that the genesis and subsequent development of the “disabilitymovement”, underpinned by the theoretical foundation of the social model, both withinthe United Kingdom and throughout the world, have created a quantum shift in themanner in which disability has been perceived, and what is now considered to be theappropriate and legitimate manner in which disability policy is to be developed andimplemented. It has now become the dominant hegemony underpinning policy-makingand service provision. In the past, and to a significant extent today, it has certainly beenthe case that disabled people have experienced, as have other marginalised groups,ostracism, discrimination and oppression, which has resulted in them being classified as“second class citizens” in the contemporary societies in which they live. The movement 18
    • has been successful in raising the profile of disability upon the political agenda, bypoignantly highlighting the social, economic and political structures, as well as thepejorative attitudes that have contributed to ascribing disabled people the status ofsecond class citizenship.Notwithstanding the significant contribution that the structuralist and historical-materialist theoreticians have made in constructing a socio-political understanding ofdisability, recently a new generation of disability scholars have emerged, who haveattempted to develop and build upon the earlier work described above. Two issues areconsidered to be of central importance within the ensuing debate. First, the dualisticCartesian distinction between “disability” and “impairment” is now beginning to bequestioned, in particular Oliver’s assertion that “disablement has nothing to do withthe body”, and that “impairment is in fact nothing less than a description of the physicalbody” (Oliver, M. 1995:4-5). It is therefore argued that an individuals’ own experience ofliving with an impairment on a daily basis, sometimes in a state of acute physical pain,has an important and valid role in experiencing disablement. Secondly, those workingwith disability studies are now beginning to question to what extent can disabledpeople be considered as a monolithic, homogeneous entity, and to what extent is theunderstanding of disablement contingent upon social and cultural factors. In otherwords, is it possible to construct a “grand theory” of disablement, that is valid andpertinent for all impairment groups, across all cultural settings? 19
    • Within the current disability studies literature, most writers would adhere to andacknowledge the general principles and axioms of the social model outlined above.However, opinion is indeed divided as to what significance should be given to thepersonal experience of individual disabled people within an analysis of disablement.Some within the disability movement argue that the discussion of the personalexperience of disabled people detracts from achieving its main objective - that is tochallenge the structure and processes that exist within contemporary society thatoppress them. It is contended that such considerations dilute the potency of the socialmodel to act as a force for political change, for it de-politises the debate. Finklestein(1996) has therefore stated:- “ ... attitudes and emotions that came from experiencing discrimination ... Writers like Jenny Morris have elevated the importance of personal, psychological in understanding disability. Such a work encouraged a shift away from thinking about changing the real world. Finding insight the experience of discrimination is just a return to the old case file approach to oppression, dressed up in social model jargon”. (Finklestein, V. 1996:11)Conversely, other disability theorists, such as Hughes and Patterson, influenced bypost-modern ideas, have argued that engaging with debates concerning the body inrelation to the notion of disablement in fact strengthens the potency of the explanatorypower of the social model. They have stated:- “The social model of disability presupposes an untenable separation between body and culture, impairment and disability, while this has been of enormous value in establishing a radical politics of disability, the cartesianized subject that it 20
    • produces sits very uneasily in the contemporary world of identity polities.. This paper is an internal critique: It argues not for the supersession, but for the expansion of the social model and it proposes and embodied, rather than a disembodied, notion of disability”. (Hughes, W, and Paterson, K. 1997:326).Hughes and Paterson (1997) have thus argued that while the social model has provideda penetrating critique of the medical model, it has nevertheless left discourses regardingthe body and impairment to the domain of bio-medicine, thus exiling the study ofimpairment from sociological examination. Furthermore, Hughes (1999) argues that thesocial model, as originally conceived, provided a pertinent critique of capitalism, buthas largely been ineffective in critiquing modernity. Consequently, maintaining therigid distinction between disability and impairment:- “ ... restricts the analytical power and ‘reach’ of disability studies: in particular, it confounds the possibility of developing a social theory of impairment which is largely dependent upon escape from Cartesian categories.” (Hughes B 1999:156).Writers such as Hughes and Paterson maintain that the relationship that exists betweendisabled people and their bodies is mediated through medicine and therapy, devoid ofpolicy and political analysis. Such an approach results in the dualism of a medicalanalysis of disabled peoples’ bodies and a political analysis of disabled peoples’ socialexistence. They therefore stated:- “In the social model, the body is rendered synonymous with its impairment or physical dysfunction. That is to say, it is defined - at least implicitly - in purely biological terms. It has no history. It is in essence, a timeless ontological foundation. Impairment is therefore the opposite of disability: it is not socially 21
    • produced. ... Indeed, there is a powerful convergence between bio-medicine and the social model with respect to the body. ... Impairment is consequently entrenched in the biomedical and reduced to its dysfunctional anatomo- physiological correlates. Yet impairment is more than a medical issue. It is both an experience and discursive construction. ... The social model of disability has not entertained debates that problematise the body”. (Hughes, B. and Paterson, K. 1997:328-329).Deborah Marks (1999) has cogently argued that the dichotomizing of disability andimpairment, as posited by the historical materialist variants of the social model,paradoxically results in the social model becoming, in fact, highly individualistic. Byexcluding a sociological analysis of experience and the body, a theoretical vacuum isthereby created.Feminist disability theorists, such as Liz Crow and Jenny Morris, concur with theanalysis presented by Hughes and Paterson, and have called for the social model ofdisability to be reconceptualised, to incorporate a sociology of impairment. JennyMorris (1991) maintained that the social model has effectively denied the fact that thephysical and emotional pain and suffering experienced by disabled people due to theirimpairments has any impact upon their practical daily living. The sharp distinctiondrawn between disability and impairment has compartmentalized bodily experiencefrom social experience - pain from politics. In addition, Liz Crow (1996) haspersuasively argued that the social model of disability has not made adequateaccommodation for the subjective experiences of pain, fatigue, depression, and to an 22
    • extent, the uncertainty that disabled people inevitably experience as a result of theirimpairment. The existence of impairment is indeed an objective reality as well as beingsubjectively experienced. She therefore states that:- “an impairment such as pain or chronic illness may curtail an individuals activities so much that the restriction of the outside world becomes irrelevant ... for many disabled people personal struggles relating to impairment will remain even when disabling barriers no longer exist” (Crow, L. 1996:9 and 209)Sally French (1994) has delineated four definitive factors that have a profound influenceupon the way disabled people experience the consequences of their impairments: 1) theprecise period in a person’s life when they acquired their impairment; 2) the relativevisibility of that impairment; 3) how “severe” the impairment is considered to be fromthe model of other people, and 4) whether the impaired individual also has otherillnesses.Furthermore, while recognizing that the concept of disablement is a socio-politicalconstruction Bickenbach et. al. questioned whether sufficient rigor has been given byprotagonists of the early versions social model to establishing the mechanisms of thecausal linkage between impairment and disability. It is indeed difficult to devise socialindices that identify and measure this linkage. Bickenbach et. al made the followinginsightful comments:- “Despite its intuitive power, the insight that disablement is a complex phenomenon in part created by the social environment cannot easily be translated into researchable questions. How precisely does the social environment create 23
    • disablement? Should we expect patterns of disadvantage linked to specific physical or mental conditions? How do we identify which aspects of the social environment are responsible for disadvantage? Which interventions will make a difference and can we measure the improvement? The data from these research questions could lay the medical model to rest, and provide disability advocates with hard evidence of how the social world ‘disables’ them. Yet these questions are too vague, multifactorial and imprecise for the basis of research. As a result, very little empirical research has been done on the fundamental question of how intrinsic features of an individual interact with features of the social environment to produce disablement.” (Bickenbach, J. et. al. 1999:1174).3.2 A Cultural Understanding of DisablementProtagonists of the historical materialist variant of the social model, such as Mike Oliver,maintained that irrespective of the category of impairment, all disabled peopleencountered “oppression”. Indeed, oppression was perceived as the commondenominator that unites all disabled people, notwithstanding differences in socio-economic or cultural background. However, it is contended here such an understandingof oppression is problematical, as both disability and impairment are socially andculturally constructed. What is means to have an “impairment” and experience“disability” is therefore, by implication, culturally defined and will vary betweensocieties. For example, consider the case of an individual who has dyslexia. In apredominantly rural agrarian society, such as South India, the fact that an individualcannot read and write is not likely to inhibit their ability to work and participate fully inlocal community life, and will not be popularly considered to be disabled, and therebyencounter oppression. However, a person who is dyslexic living in a western-based 24
    • society is more likely to be unemployed, for in a myriad of ways, in order to functionwithin society, there is a prerequisite for an individual to be literate.The Department for Education and Employment, as part as its last Labour Force Survey,published in Autumn 1999, examined the relationship between disability andemployment (Department for Education and Employment, 1999). The Survey foundthat although disabled people constitute nearly a fifth of the working-age population inGreat Britain, they nevertheless constitute one-eighth of all those in employment.Furthermore, disabled people are over six times as likely an the able-bodiedcounterparts to be unemployed and claiming state benefits. The Survey also found theemployment rates vary accord to type of impairment. Some impairment groups, such asthose with diabetes, skin conditions and hearing impairments attain relatively highemployment rates. However, three quarters of those with mental illness and two-thirdsof those with learning difficulties are unemployed (Department for Education andEmployment, 2000). It can there be appreciated that the prospects of disabled peoplegaining employment are far greater in South India than they are in a western countrysuch as Great Britain.The above also illustrates that the notion of impairment, as conceived by the historical-materialists, is very “physicalist” in its understanding. As demonstrated by thedisability theorists cited above, the notion of an impairment is indeed a more 25
    • sophisticated phenomenon, that can encompass cognitive and psychologicalmanifestations. Those with cognitive difficulties and mental illness may in fact havebodies that the majority would deem to be “normal”, but this does not necessarily meanthat such individuals do not encounter the negative connotations and reality ofexperiencing impairment.Recently, the World Health Organisation has also begun to recognise the symbioticrelationship between disability and impairment, and that both are socially constructed.Consequently, in 1993, they began the process of revising their 1976 classification ofdisability, handicap and impairment. According to the newly devised scheme, themultifaceted nature of disablement is essentially comprised of three principalcomponents, which interact with each other. These have been defined in the followingmanner:-Box 2 The International Classification of Impairment, Activities and Participation: A Manual of Dimensions of Disablement (World Health Organisation, 1997:14)  “Impairment is a loss or abnormality of body structure or of a physiological or psychological function.  An Activity is the nature and extent of functioning at the level of the person. Activities may be limited in nature, duration and quality”.  Participation is the nature and extent of a person’s involvement in life situations in relation to Impairments, Activities, Health Conditions and Contextual factors. Participation may be restricted in nature, duration and quality”. 26
    • Emphasis is now placed upon highlighting the social aspects of disability. The newlydevised classification has abandoned the word “disability” and “handicap” altogether,replacing these terms with “activities” and “participation”. It emphasises the dynamicrelationship between the health condition of the individual, together with their own“personal” characteristics as well as the broader social environment. All these factorsare seen as determining how an impairment affects the participation of that individual.WHO, commenting on the revised classification, stated:- “The new classification that has been devised by the World Health Organisation is an attempt to measure the multifaceted dimensions of disablement. Furthermore, the notion of disablement is not perceived in terms of an attribute of a person, but as a complex collection of conditions many of which are created by the social environment. Hence, the management of the problem requires social action and it is the collective responsibility of society to make the environmental modifications necessary for the full participation of people with disabilities into all areas of social life. The issue is, therefore an attitudinal or ideological one which requires social change, while at the political level it is a matter of human rights”. (WHO, 1997:6)WHO’s latest conceptualisation of disablement constitutes a substantive improvementupon the previous classification, for it attempts to take the social dimensions ofdisablement fully into account, indicating a movement along the continuum from amedical to a social understand of disablement. It is also aware of the cultural andmaterial factors which sometimes have a significant bearing upon a particularindividual’s ability to participate in contemporary society. Thus, the new classificationrecognises that poverty, the lack of adequate housing, or inferior environmental factors 27
    • such as inadequate sanitation, as well as the gender status of a disabled individual, maywell affect their ability to participate in contemporary society.Bickenbach et. al. identified WHO’s revised classification of disablement as attemptingto encompass a “biopsychosocial” conception, principally by providing a syntheses ofthe medical and social perspectives of disability. In commenting upon the symbioticrelationship between the malfunction of the body, and the manner in which society isstructured, Dimitris Michailakis stated:- “ ... the person-environment approach implies a view of handicap as something that involves the individual’s functional limitation, as well as his environment will lead to another understanding. Handicap is not a property, a characteristic of the individual in the first hand, but something that develops between the individual and the environment. ... The inability to walk, to talk, to see and so on (functional limitations) is clearly distinguished in the person-environment approach from the inability to go to school, to work and generally participate in community life. A functional limitation becomes a handicap when the environment impedes action and participation. ... The implications of functional limitations vary according to sociol-economic circumstances of each society and the provisions it makes for its citizens. From a person-environment approach, handicap is a problem which exists in relation to society and which each society, therefore, has the capacity to reduce or control” (Michailakis, D. 1997: 22-23).Imrie (1997) also found the original conceptualization social model to be problematical.By purporting that the origins of oppression are located exclusively in “attitudes”, it isdifficult to determine their social location, and how these in turn result in oppressiveaction. The model is deficient in failing to analyze the socio-political contexts in whichattitudes and values are constructed, and how they are in turn transformed intooppressive actions and practices. 28
    • A further question arises concerning the appropriateness in developing countries of thewestern-based notion of empowerment, which presupposes that rights are exercisedand that decisions are made in accordance with the preferences and wishes of theindividual. Such an individualised notion of empowerment, as espoused by theinternational disability movement runs contrary to accepted social customs andpractices found within many developing countries. In societies such as found in Asia, itis customary that all major decisions, for example, who one should marry or thepurchase of property or career decisions, are taken not by the individual, butcollectively through consultation within extended family and kinship networks. This isparticularly the case in rural areas, and operates irrespective of whether disability ispresent within the family. Thus, a focus on rights and decision-making practices rootedin the ideology of individualism is, in many societies, particularly in an African andSouth-Asian context, often at variance with established cultural and social norms andpractices. It is surely right to question the efficacy of proselytising western-basedindividualism, which runs contrary to long standing local practices.A further matter for discussion is the most appropriate strategy for achieving socialchange so as to result in the construction of a non-disablist world. As the previoussection has shown, one of the principal tenets of the social model is that disabled peopleexperience discrimination and social oppression, resulting in disabled people living 29
    • within a “disabling world”. Upon the supposition that disabled people are indeed anoppressed group, the movement has advocated that conflict should be used incombating such oppression and discrimination.While appreciating the foundation of such sentiments, and without denying the validityof the assertion that disabled people do indeed face discrimination and oppression, it iscontended that disability is a far more complex phenomenon than can be solely andadequately explained by social oppression and discrimination. It is my experience thatvast numbers of people, rather than actively oppressing disabled people, are in factfearful and ignorant of disability, which leads them to relate to disabled people ininappropriate and often demeaning ways. In agreement with this position, the feministdisability writer, Jenny Morris stated:- “Our disability frightens people. They don’t want to think that this is something that might happen to them. So we become separated from common humanity, treated as fundamentally different and alien. Having put up clear barriers between us and them, non-disabled people further hide their fear and discomfort by turning us into objects of pity, comforting themselves by their own kindness and generosity”. (Morris, J. 1991:192).Oppression is often of an unwitting nature. If oppression and discrimination were thesole factors in the creation of a disablist society, then conflict might be the mostappropriate strategy to adopt. However, if as is contended here, fear and ignorance alsoprovide a significant explanation to societal attitudes towards disability, then a moreappropriate and pertinent strategy for the creation of a non-disablist society might be 30
    • through the medium of education. It is an undisputable fact that disabled people are inthe minority within society, albeit a significant one, comprising approximately tenpercent of the world’s population. Disabled people, in order to create a society which isindeed non-disablist and which secures effective, full citizenship, needs to foster andbuild alliances with their able-bodied peers, and this is best achieved through consensusbuilding and education.3.3 Conclusion - The Future of Disability Theory: Towards an “Affirmation” ModelThis paper has so far outlined the genesis and subsequent development of the socialmodel of disability, as well as highlighting some of the difficulties that are inherent in itsuniversal application across cultural settings. The social model of disability continues toevolve and develop. John Swain and Sally French (2000), building upon the intellectualwork described above, have outlined an “affirmation” model of disability, which seeksto “celebrate the difference” that characterise the lives of disabled people. It is thereforecontended that disabled people can be “proud” the fact that they are different from themajority of the population. Swain and French begin their analysis by rejecting thetragedy conception of disability as purported by the medical model. They proceed bymaintaining that it is not possible to make a stark distinction between those who aredisabled and those who are not, since all people, to some extent have a degree ofimpairment, but do not necessarily encounter the negative consequences of disability. 31
    • Those who where spectacles to compensate for low vision are a case in point. Neithercan a stark distinction be maintained between those who encounter oppression andthose who do not, for it is possible disabled people themselves to be oppressors, byhaving racist, homophobic or sexist attitudes.They further contend that the social model of disability has clearly shown howcontemporary society has oppressed and discriminated against disabled people.However, in contrast the majority of most disability studies theorists, they maintain thatthe vast majority of disabled people accept the analysis of the social model. They havecandidly stated:- “The social model was borne out of the experiences of disabled people, challenging the dominant individual models espoused by non-disabled people. Nevertheless, it is our experience that many non-disabled people readily accept the social model, albeit superficially and at a very basic conceptual level. Non-disabled people can generally accept that a wheelchair-user cannot enter a building because of steps. ... Non-disabled people are much more threatened and challenged by the notion that a wheelchair-user could be pleased and proud of the person he or she is” (Swain J. and French, S. 2000:570).Ascribing to the notion of an affirmative model of disability questions the analysis ofearly variants of the social model, since it is argued that the adoption of the precepts ofthe latter does not necessarily result in a non-tragic view of disablement. Swain andFrench again state:- “While the social model of disability is certainly totally incompatible with the view that disability is a personal tragedy, it can be argued that the social model, in itself, underpinned a non-tragedy view. First, to be a member of an oppressed group within society does not necessarily engender a non-tragic view. There is, 32
    • for instance, nothing inherently non-tragic about being denied access to buildings. Secondly, the social model disassociates impairment from disability. It, thus, leaves the possibility that even in an ideal world of full civil rights and participative citizenship for disabled people, an impairment could be seen as a personal tragedy” (Swain, J. and French, S. 2000:571).Swain and French further develop their thesis by stating that, in contrast to the tragicview of disablement, the occurrence and onset of an impairment can result in animprovement of the quality of lives an individual disabled person. Examples are givenof disabled people being able to “escape” the underlying social oppressive practices andstructures that characterise some societies. Thus, disabled people may indeed beliberated from the responsibilities in the realms of sexual relations, responsibility withinthe domestic household, and may be more attuned to comprehend the oppressionencountered by other minority groups.The above demonstrates that it is possible for disabled people is inculcate and project apositive identity, thereby celebrating the diversity and richness of the lives that theyinvariably lead. In summarising the philosophy of an affirmative model of disability.Swain and French stated:- “The affirmative model directly challenges presumptions of personal tragedy and the determination of identity through the value-laden presumptions of non- disabled people. It signifies the rejections of presumptions of dependency and abnormality. ... Embracing an affirmative model, disabled individuals assert a positive identity, not only in being disabled, but also in being impaired. In affirming a positive identity, disabled people are actively repudiating the dominant view of normality. The changes for individuals are not just transforming of consciousness as to the meaning of ‘disability’, but an assertion of the value and validity of life as a person with impairment”. (Swain, J. and 33
    • French, S. 2000:578).Swain and French conclude their analysis by stating that embracing an affirmative viewof disablement in fact strengthens the political leverage of the disability movement.Disabled people can not only look towards a future society devoid of structural,environmental and attitudinal barriers, but one that can “celebrate difference and valuespeople irrespective of race, sexual preference, gender, age and impairment” (Swain, J.and Fench, S. 2000:580).The desire to celebrate diversity and difference, and take pride in the positive value ofliving with impairments, has also been expressed by those who are deaf. Some “Deaf”people are of the opinion that they are not in fact disabled, but constitute a distinct andcoherent social minority, complete with their own culture and language. A distinctionis drawn between those how can hear, and those who cannot. By implication, then,those with a physical disability such as paraplegia or cerebral palsy would, in the mindsof some of those who are deaf, as belonging to the latter category. Ladd and John(1991), in investigating the relationship between the “Deaf Community” and “disabledpeople” have stated:- “ ... we do not want to mainstream society to restructure so that we can be part of it. Rather, we wish for the right to exist as a linguistic minority group within society ... Labelling us as ‘disabled’ demonstrates a failure to understand that we are not disabled within our own community. ... Many disabled people see Deaf people belonging with them outside the mainstream culture. We, on the other hand, see disabled people as ‘hearing’ people in that they use a different language to us, from which we are excluded, and see them as being members of society’s 34
    • culture” (Ladd, P. and John, M 1991:14-15).However, the position outlined above has been criticised from within the Deafcommunity itself. By claiming that they constitute their own distinctive cultural identity,Mairian Corker argues that protagonists of such a position are in fact, accepting as a faitd’compli, thee norms and social mores of a disablist society, which is invariablyoppressive. She states:- “ ... the allusion to withdrawal from mainstream society suggests withdrawal from something; all accounts suggests that this something is cultural and linguistic oppression. But Western society, together with the dominant human services culture and its governance and legal systems which at present control to a large extent how we live, sill view all dead people, including those who are Deaf, in terms of the individual/medical model. Hence, though sign language is increasingly acknowledged as a viable means of communication, it does not follow that there is a widespread cultural acceptance within such frameworks for thinking and service development” (Corker, M. 1998:29-30).References:Abberley, P. (1987) “The Concept of Oppression and the Development of a Social Modelof Disability”, Disability, Handicap & Society, 2(1): 5-19.Albrecht, G. and Levy J. (1981), “Constructing Disabilities as Social Problems” inAlbrecht, G. ed., Cross National Rehabilitation Polices: A Sociological Perspective, Sage,London.Barnes, C. (1991), Disabled People and Discrimination in Britain: The Case for Anti-Discrimination Legislation, Hurst & Co, London.Barton, L. (1993), “The Struggle for Citizenship: The Case of Disabled People”,Disability, Handicap & Society, 8(3): 235-248.Bickenbach, J., Chatterji, I., Badley, E. and Ustun T. (1999), “Models of Disablement,Universalism and the International Classification of Impairments, Disabilities and 35
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